外科手術が未熟児網膜症の重症化に及ぼす影響

Influence of general surgery on progression of retinopathy of prematurity

　1999年までの10年間に当院のNICUに入院し，外科手術が施行された超・極低出生体重児25例50眼の経過記録から，外科手術が未熟児網膜症の重症化に及ぼす因子を検討した。手術の内容は，壊死性腸炎に対する開腹術5例，頭蓋内出血へのV-Pシャント7例，動脈管開存症への開胸術13例であった。II型の未熟児網膜症は，外科手術時の在胎修正週数が30週以前で外科手術時の体重が900g未満の症例に集中して発症した。この条件を満たす症例に外科手術を行う場合には未熟児網膜症の重症化の可能性が大きく，格別の注意が必要である。

We tried to identify the risk factors for aggravation of retinopathy of prematurity following general surgery. The cases comprised 50 eyes of 25 very low birthweight infants treated in our Neonatal Intensive Care Unit (NICU) during 10 years through 1999. They received either abdorninal surgery for necrotizing enteritis 5 cases, creation of ventriculo-pleural shunt for intracranial hemorrhage 7 cases, or ligation of patent ductus arteriosus 13 cases. Type Ⅱ retinopathy of prematurity developed at a very high incidence when surgery was performed before 30 weeks of postconceptional age in infants weighing less than 900g at the time of surgery. The finding shows that particularly close attention is necessary when general surgery is performed on infants belonging to the above category.